Individual
KELLY CARBONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3551 N BROAD ST, PHILADELPHIA, PA 19140-4160
(215) 430-4022
(215) 430-4079
Mailing address
PO BOX 8500, PHILADELPHIA, PA 19178-0001
(813) 281-8478
(813) 281-8113
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
TP006868D
PA
Other
Enumeration date
05/16/2011
Last updated
05/16/2011
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